title: HIV-1 transmission during early antiretroviral therapy: evaluation of two HIV-1 transmission events in the HPTN 052 prevention study.
abstract: In the HPTN 052 study, transmission between HIV-discordant couples was reduced by 96% when the HIV-infected partner received suppressive antiretroviral therapy (ART). We examined two transmission events where the newly infected partner was diagnosed after the HIV-infected partner (index) initiated therapy. We evaluated the sequence complexity of the viral populations and antibody reactivity in the newly infected partner to estimate the dates of transmission to the newly infected partners. In both cases, transmission most likely occurred significantly before HIV-1 diagnosis of the newly infected partner, and either just before the initiation of therapy or before viral replication was adequately suppressed by therapy of the index. This study further strengthens the conclusion about the efficacy of blocking transmission by treating the infected partner of discordant couples. However, this study does not rule out the potential for HIV-1 transmission to occur shortly after initiation of ART, and this should be recognized when antiretroviral therapy is used for HIV-1 prevention.
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Ping
authors.forename: Cassandra B
authors.initials: CB
authors.lastname: Jabara
authors.forename: Allen G
authors.initials: AG
authors.lastname: Rodrigo
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hudelson
authors.forename: Estelle
authors.initials: E
authors.lastname: Piwowar-Manning
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Susan H
authors.initials: SH
authors.lastname: Eshleman
authors.forename: Myron S
authors.initials: MS
authors.lastname: Cohen
authors.forename: Ronald
authors.initials: R
authors.lastname: Swanstrom
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1; D006801:Humans
chemical_list: D019380:Anti-HIV Agents